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BioMed Research International
Volume 2016, Article ID 4054513, 10 pages
http://dx.doi.org/10.1155/2016/4054513
Review Article

Esophageal Stent for Refractory Variceal Bleeding: A Systemic Review and Meta-Analysis

Department of Gastroenterology, General Hospital of Shenyang Military Area Command, Shenyang 110016, China

Received 18 February 2016; Revised 15 June 2016; Accepted 20 June 2016

Academic Editor: Michel Kahaleh

Copyright © 2016 Xiao-Dong Shao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Preliminary studies suggest that covered self-expandable metal stents may be helpful in controlling esophageal variceal bleeding. Aims. To evaluate the effectiveness and safety of esophageal stent in refractory variceal bleeding in a systematic review and meta-analysis. Methods. A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 1970 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model. Heterogeneity was assessed using test. Results. Five studies involving 80 patients were included in the analysis. The age of patients ranged from 18 to 91 years. The mean duration of follow-up was 46.8 d (range, 30–60 d). The success rate of stent deployment was 96.7% (95% CI: 91.6%–99.5%) and complete response to esophageal stenting was in 93.9% (95% CI: 82.2%–99.6%). The incidence of rebleeding was 13.2% (95% CI: 1.8%–32.8%) and the overall mortality was 34.5% (95% CI: 24.8%–44.8%). Most of patients (87.4%) died from hepatic or multiple organ failure, and only 12.6% of patients died from uncontrolled bleeding. There was no stent-related complication reported and the incidence of stent migration was 21.6% (95% CI: 4.7%–46.1%). Conclusion. Esophageal stent may be considered in patients with variceal bleeding refractory to conventional therapy.